PTSD, Post Traumatic Stress Disorder, is defined precisely as it sounds, stress derived after witnessing a traumatic event.

But what is that exactly?  

The Diagnostic and Statistical Manual of Mental Disorders (DSM), per the American Psychiatric Association states the critera to be diagnosed with PTSD is:

Criterion A (one required)  

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

  • Direct exposure

  • Witnessing the trauma

  • Learning that a relative or close friend was exposed to a trauma

  • Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B (one required)  

The traumatic event is persistently re-experienced, in the following way(s):

  • Unwanted upsetting memories

  • Nightmares

  • Flashbacks

  • Emotional distress after exposure to traumatic reminders

  • Physical reactivity after exposure to traumatic reminders

Criterion C (one required)  

Avoidance of trauma-related stimuli after the trauma, in the following way(s):

  • Trauma-related thoughts or feelings

  • Trauma-related reminders

Criterion D (two required)  

Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

  • Inability to recall key features of the trauma

  • Overly negative thoughts and assumptions about oneself or the world

  • Exaggerated blame of self or others for causing the trauma

  • Negative affect

  • Decreased interest in activities

  • Feeling isolated

  • Difficulty experiencing positive affect

Criterion E (two required)  

Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

  • Irritability or aggression

  • Risky or destructive behavior

  • Hypervigilance

  • Heightened startle reaction

  • Difficulty concentrating

  • Difficulty sleeping

Criterion F (required) 

Symptoms last for more than 1 month.

Criterion G (required) 

Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H (required) 

Symptoms are not due to medication, substance use, or other illness.

Two specifications:

  • Dissociative Specification. In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:

    • Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).

    • Derealization. Experience of unreality, distance, or distortion (e.g., "things are not real").
       

  • Delayed Specification. Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.